tv Sanjay Gupta MD CNN July 10, 2011 7:30am-8:00am EDT
good. our dr. sanjay gupta is taking a look in our special edition of "sanjay gupta m.d." coming up. last month president obama announced plans to start bringing down the number of u.s. troops in afghanistan. but still u.s. troops are going to be there for years to come. come fall it will be a full decade we've been at war. so this week and next we're taking a closer look at an aspect that's easy to miss, at least until your life is on the line. i'm talking about the impact this war has had on medical care, no the just for wounded troops, but also here at home. one pretty stark example is the care that saved the life of congresswoman gabrielle giffords. a bullet through the head. the kind of wound you might see in combat. dr. peter reed was running the emergency room that day. but he learned his trade in iraq with the navy. he says with the wound like giffords' had, a decade ago, a lot of doctors would have given up before they even started. >> for most handgun injuries
through and through to the head, the chance of them going to the operating room are exceedingly low. but now a days, now that we've gotten our experience about penetrating trauma from the recent iraq experience, we're aggressive about getting to the operating room. >> in iraq and afghanistan, we've learned to do as much as possible, right away, don't wait until you get to the hospital tent. now they teach that same principle here as well. >> for the congresswoman, the goal of the paramedics in a situation like this is to literally get her into the ambulance and get her here as quickly as possible. >> scoop and run. >> the war has lessons for neurosurgeons, too. what we know is that a through-and-through bullet injury causes direct damage to the brain. it's the secondary damage due to swilg where you're trying to minimize the risk. >> a surgeon cut away part of her skull to relieve pressure from swelling. called a hemi craniectomy.
the battlefield drives break-throughs, like quick-clot. pack it in a wound to stop bleeding, it works, fast. surgery directed by remote control. >> we're here controlling this robot. in santa barbara, we're here in texas. dr. chung does this all the time. he could be controlling a robot in this hospital or controlling a robot anywhere in the world. meanwhile, a whole field has developed to help a generation of soldiers missing arms and legs. military money helped fund this robotic arm from inventor dean cammen. >> you did deserve that. technology can be miraculous. but sometimes it can also be as simple as a mirror. nick lost a leg when a missile hit his truck in iraq. >> i can feel the rush of the efp going through the vehicle. of the change of pressure and then also smoke.
>> in rehab, the pain was unbearable. until doctors tried a new approach. >> what we're seeing here basically is just using a $20 mirror to basically make it seem like his right limb is still there. that's all it is. what that does, basically is coordinates his visual, his actually visualizing this with what's known as his position of the right leg. coordinating those two things together really helps. >> the brain is tricked. it sees the leg. it shuts off the pain signal. >> now, finding a better way to treat pain has become a greater focus for military and for civilian doctors alike. there's sort of this new understanding of pain. it's not just the injury itself, to understand pain you have to understand the way it changes your entire nervous system. the nerves can keep sending pain signals, even after the original injury is healed. joining me now, my friend barbara starr, cnn's pentagon correspondent. she's seen these injuries
firsthand and has ridden from the troops in afghanistan back to the states and a lot of hospitals around the united states. i know you're fascinated with this topic. let me start with pain. this is a vexing problem for military and civilian doctors alike. you've talked to the dalters at walter reed. what are they telling you about their approaches? >> they're telling me just what you described, a new way to address pain, pain management. whether you suffered from a traumatic injury from war or pain from a disease or something you're dealing with as a regular civilian. looking at it, not just as a symptom. but as a disease, if you will of the nervous system. how do you interrupt that pain signal that goes to your brain. you get injured, you have a problem, the pain signal goes to your pain. how do you very quickly interrupt it so it doesn't become a neurological pattern? they're looking at things like regionalan anc regional, anesthetics, nerve
blocks, if you have an injury to your arm, do a nerve block right away so the pain signal doesn't get started and go right to your brain. they're having a lot of success with this. and what they're learning in dealing with so many wounded troops may help them in the future. >> stop the cascade, give the pain medication early. don't brave it out. to stop the cascade. some of our greatest lessons in medicine have come from the battlefields throughout history. you've seen some of that as well. >> people don't realize, it's fascinating topic. it goes back to george washington and the revolutionary war. when there was the first real use of smallpox vaccines or inoculations, you know, think about that. all the way into the civil war, when they started doing am pew dags tagss and when they have large numbers of wounded, how to triage. how to prioritize, if you've got
cases coming in, who do you deal with first. wars are great arenas for learning medical lessons. >> triage is how to do things now, but to think it had its genesis in the war is fascinating. what about vietnam? >> in vietnam, it was the first use of helicopters landing right on the battlefield, under fire, to take wounded troops out of there and get them to medical care. the so-called golden hour began to emerge. what you've reported on, getting somebody off the battlefield. getting them to care within an hour. now we sort of take it for granted. if you get injured, if you're in a traffic accident on the highway, hopefully not. if you're in an accident in a building or a factory, a helicopter from your local emergency room, may come land very quickly and take you away. that's the lesson from vietnam. >> and from the battlefields, it's interesting, because you still see it, you know, in daily life at big hospitals, but even
on the battlefields, they have started taking medical commodities, these forward tents and moving them further forward for that same reason. there's been a lot of lessons more recently from iraq and afghanistan. you've been talking to people about that. what have you been hearing? >> what doctors are telling us, it's sad to think, but a basic fact. tens of thousands have been wounded in this war. you have this giant population of, that they are learning from. and what they're basically learning, they will tell you, i think is dynamic innovative, fast-moving medical care. try new things, try and see what you can accomplish with new techniques, new procedures. because they can't stick to just the old way of doing business. these kids are coming back with traumatic injuries that are very, very tough. they got to find a way to deal with them. and you find doctors and nurses out there trying new things, things that may be in your emergency room, not too far from now. >> i'm not quite sure how to say
this, but i think on the battlefield you are forced to innovate in ways that in civilian medicine, you're not. it becomes so rote here in hospitals, this is fascinating stuff. let's keep talking about it we're going to talk about healing the brain. there's a new approach that's striking you'll want to hear this and we'll be back with more battlefield breakthroughs right after this. so you can get back to playing "angry birds." it lets you access business forms on the go, fire off e-mails with the qwerty keypad, and work securely around the world so you can get back to playing "angry birds." it's the android-powered phone that mixes business with pleasure. so let's get our work done, america, so we can all get back to playing "angry birds." the motorola expert from sprint. trouble hearing on the phone? visit sprintrelay.com. really? 25 grams of protein. what do we have? all four of us, together? 24. he's low fat, too, and has 5 grams of sugars. i'll believe it when i--- [ both ] oooooh... what's shakin'? [ female announcer ] as you get older,
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traumatic brain injury is often referred to as a signature injury of the war we're in right now. the same sore of injury as a concussion on the football field or in a car crash. mending the brain is a tremendous challenge. cnn's pentagon correspondent, barbara starr went to fort campbell in kentucky for a firsthand look. >> this is an intense simulation. it's hot, loud, and stressful. staff sergeant aaron potter and other troops are voluntarily putting themselves through this grueling episode of fake blood, and plastic wounded models for one reason -- after weeks of behavioral therapy, all of these soldiers are trying to show they can get back to their daily work -- combat.
>> these are only paintball guns, but these troops all brain-injured in the war, are determined to succeed. this is just one example of how the war may be affecting your medical care. >> doctors here at fort campbell have developed a new approach to treating the type of war zone brain injuries that these troops are trying to recover from. it's a treatment you may find someday at your local hospital. in 2009, potter was knocked unconscious when hit by three ieds at one in iraq. he told us under the first round therapy, he broke down under the stress. now, as he drives a convoy simulator, he is determined to make it. >> i really struggle with multitasking and getting things done, multiple things done at one time. whereas before, i really never had a problem with that. now, you know, i don't have any, i mean there's slight problems, but i'm a lot better off than i
was. >> therapy treatment can be both simple and complex. identify the parts of the brain that have suffered trauma. dark areas here. identify what tasks the patient is having trouble with, that relate to that part of the brain and then go to work. exercising the brain, regenerating and rear energizing specific brain functions. when he came home to his wife and two sons from iraq, potter's brain injury left him unable to concentrate, focus on tasks or even deal with the basic chores his wife, tiffany, asked him to do around the house. >> within a week or two, you started to pick up on how either he didn't understand what i was saying to him, sim spell things that norly did, they just, he couldn't do them. either he couldn't do them or just didn't understand how to do them. >> tiffany urged him to get help at the nearby military clinic.
neither of them realized at the time, it was a brain injury. the first time you met staff sergeant aaron potter, what did you see? what was going on with the staff sergeant. >> some of the things that he was having to deal with were making it difficult for him to do his job well. so it was really a time for us to come together and say, hey, look, we can help, we can make a difference here. >> step into the machine, facing the screen, we'll get you all hooked up. >> lou do you exercise the injured parts of your brain? here there are exercises for balance, puzzles for concentration and video games to teach relaxation. a treatment that can help for those suffering any type of brain injury. a sports injury, a car accident or a gunshot. the doctor says he would like to see this comprehensive approach migrate through civilian care. not just in major metropolitan trauma centers, he thinks there may be other implications for treating brain disorders.
>> can you retrain a brain that may be suffering from alzheimer's or parkinson's? >> we believe you can, barbara. and you do that by exercising the part of the brain which is responsible for that function. >> now you're not saying you can cure these diseases, to be clear. >> not at all. what we're saying we can slow, maybe even for periods of arrest, the process decline in the brain. >> logan says there's no reason this type of therapy would work only for soldiers it could help drug addicts and alcoholics recover brain function. when it comes to changing the brain and behavior, he says, counseling just isn't enough. >> sit with us for a moment. >> okay. >> join the circle. >> the circle of trust here. >> aaron sits down for evaluation. initial laughter turns serious,
for aaron, all the hard work now comes down to the finish line. his therapy team tells him he's done well. if he still wants to, he's likely to serve again. >> and joining me again is barbara starr. again, just really interesting stuff, the idea of taking medicine and plying it to civilians from the battlefield. you are looking at training for the brain here. you look at that and you ask yourself, what evidence do you have that it works. >> well, the doctors are telling us at fort campbell, that their best evidence right now is their track record. that the major percentage of the troops that go through the program are able to demonstrate enough progress to return to duty, to return to combat. can it work in the civilian world? it remains to be seen. it's the kind of thing that is already happening at major trauma centers. i think we have seen some of this in the massive rehabilitation that congresswoman giffords got, for example.
what they're talking about is trying to expand this. so it's not just to the major trauma center, it's not just with the u.s. military. put it in the emergency room across the country. >> what about other neurological problems? >> that's what they're trying to look at. if you have alzheimer's, for example, can you identify the part of the brain and develop an exercise program for your brain that will help you. it's not going to cure it, but it will keep that part of your brain going. and the other thing they're looking at are people who suffer from drug use or alcoholism. it injures their brains, their brains become less than they were due to this abuse. so you know, just psychological counseling and that type of rehab won't be enough. you got to work on those parts of your brains, that are suffering these injuries. >> fascinating stuff. we'll have more with barbara as well. next week we're going to talk about a program for regular doctors out there, nurses as well in the states that gets them ready to go into the war
zone. thanks a lot. up next, we're going to talk to a harvard professor who went to war. >> what happens when the brain gets hit by a blast wave and it slams up against the inside of the skull. >> he came back as a man on a mission to revolutionize our understanding of what exactly happens when a blast damages the brain. stay with us. nothing helped me beat arthritis pain. until i tried this. it's salonpas. pain relief that works at the site of pain... up to 12 hours. salonpas. announcer: when life's this hard, it's no wonder 7,000 students drop out every school day. visit boostup.org and help kids in your community stay in school.
you know you run across a lot of interesting people in my line of work. not many like kit parker. he's a bioengineer and back in 2001 he was working to develop these drugs for heart disease. he just landed his dream job. he was a professor at harvard. he was an army officer and there was something else he had to do first. kit parker always wanted to be a bioengineering professor at harvard. he thought he was going to develop the next great heart medicine. in 2002 when he was offered his dream job, there was a catch. he was in the army reserves and he signed up with a unit that he
knew was headed to battle. army major kit parker told harvard. >> hold the job. i got to go fight. i took off for a year to go fight in afghanistan. >> reporter: he spent much of 2002 and 2003 near kandahar, hunting for taliban. he came back to harvard, but in 2009, with the national guard unit, he went back to afghanistan. >> and so i spent a lot of time with route clearance units looking for ieds and we got hit several times and vehicles in front of me blown up. my vehicle never got hit. i was very lucky. when you run up there and pull open the door of that mwrap and see your injured buddies you never forget that sight. >> reporter: this time back home he began to explore the science of brain injury. >> what happens when the brain gets hit by a blast wave and slams up against the inside of the skull. >> reporter: with colleagues at northeastern university parker built new tools to study how a
blast affects the brain. it could be years before this leads to new treatments but parker hopes eventually will have a broad impact. >> concussions that your favorite football player suffers or the head injury you get when you're in a car accident and your head snaps forward or shaken baby syndrome, these are all examples of nonpenetrating head injuries that can cause a traumatic brain injury. >> reporter: today his harvard lab is humming with students. more than half a dozen are veterans. >> we're very focussed on this because these are our guys. this could have been us. it might still be us. it brings a certain level of urgency to what we're trying to do. >> i'll tell you, it's just a creative way of looking at some pretty tough problems. we're going to have much more next week as well on some of these battlefield breakthroughs. we're switching gears. less than a month away from our new york city triathlon. i'm a little nervous. next you will meet somebody racing with me this year.
in order to finish she tells us she has to overcome one of her biggest fears. almost tastes like one of jack's cereals. fiber one. uh, forgot jack's cereal. [ jack ] what's for breakfast? um... try the number one! [ jack ] yeah, this is pretty good. [ male announcer ] half a day's worth of fiber. fiber one.
my favorite part of the show, when my producers and i launched the triathlon challenge we were looking for something specific, for people that wanted to transform their lives, not only physically but mentally. cas has put herself to the test on this very issue. before our challenge cas had never really been swimming and none of it outside a swimming pool. then we took her and the rest of the six-pack to hawaii and cas went to the ocean for the first time. we're going to talk to her about that. joining us from her home outside chicago. good to see you via satellite. let me get right to it here.
the first time you did that open water swim in hawaii you said you were pretty nervous. the coaches said you swam further than they thought you would be able to. what was that experience like, stepping into the open water for the first time? >> the first time, you know, they took us to open water and when i saw the ocean, i really immediately past the waves. then tim who was there to coach us, said come on, you know, i'll take you. >> a lot of people have these exact same problems which is what i think i told you in hawaii. you were making a goal to focus on your open water swims mentally as much as physically. how is that going for you? >> it's been going well. after i came back from hawaii, i've been doing some open water swim clinics and you know, they have been teaching me all the things that i need to know to
swim in open water. how to sight, you know, how to swim in a straight line when i cannot see the bottom. and so those are techniques that, you know, i'm practicing. i'm still learning. it's coming along much better now than it was when i was in hawaii. how would you say you're different overall. this has been several months since you signed on to thises and we first met. how are you different as a person as a result of this? >> i think i'm much more confident when i cannot see the bottom. i'm much more confident doing distances in open water. so i think just being comfortable in open water is probably the biggest change that i've experienced. >> you look great, by the way. this is about fitness, more than anything else, but you look fantastic. i can't wait to cross that finish line with you. coming up pretty soon. >> okay. thank you. >> thanks, cas. if you want to follow along with me, cas, or any of the other members of the six-pack, check